EFFECT OF DEXMEDETOMIDINE AND MAGNESIUM SULPHATE AS ADJUVANTS TO BUPIVACAINE IN PARAVERTEBRAL BLOCK FOR UNILATERAL BREAST CANCER SURGERY
Ahmed H Bakeer, Mohamed K Hamza*, Mohamed F El-Emady*
Department of Anesthesia and Pain Relief, National Cancer Institute, Cairo University and *Department of Anesthesia, Faculty of Medicine, Cairo University
Objective: To compare the postoperative analgesia after paravertebral block with bupivacaine with addition of magnesium compared to dexmedetomidine in patients undergoing unilateral conservative breast surgery Methods: Sixty adult patients undergoing unilateral conservative breast surgery were included in this prospective randomized study. After placing a catheter in T5-T6 paravertebral space, paravertebral block was activated with 18 ml of bupivacaine 0.5% plus 1 μg/kg dexmedetomidine in 2 ml of 0.9% saline (Group D) or 18 ml of 0.5% bupivacaine plus 150 mg magnesium sulphate in 2 ml 0.9% saline (Group M). General anesthesia was instituted in all patients using a standardized technique. Postoperative pain was assessed by visual analogue scale (VAS) score. The patients were given first top up dose through paravertebral route if VAS score exceeded 3. Duration of analgesia, total requirement of bupivacaine in 24 hours were noted. Results: Mean duration of analgesia was longer in Group D (304±14 min.) compared to Group M (171±19 min., p < 0.001). Mean total consumption of bupivacaine was 82±10 mg in Group D and 142±11 mg in Group M (p < 0.001). Conclusion: Addition of dexmedetomidine as an adjuvant to bupivacaine in paravertebral block significantly prolongs the duration of analgesia and decreases bupivacaine requirements compared to adding magnesium to bupivacaine.